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Trabecular Bypass Surgery
Published in Neil T. Choplin, Carlo E. Traverso, Atlas of Glaucoma, 2014
Toby Y.B. Chan, Iqbal Ike K. Ahmed
In a prospective case series, Francis et al. reported 1-year results in 304 eyes that had combined cataract surgery and trabectome. IOP improved from 20.0 ± 6.3 mmHg to 15.5 ± 2.9 mmHg with a corresponding reduction in glaucoma medications from 2.7 ± 1.1 to 1.8 ± 1.3. Blood reflux was again seen in 78% of patients but all resolved in a few days.32 Most recently, a cohort study with pseudoexfoliative and primary open-angle glaucoma patients showed that trabectome (with or without cataract surgery) achieved IOP in the mid-teens in both types of glaucoma although slightly more IOP reduction was seen in pseudoexfoliative patients. The success rate was also higher in the combined trabectome-IOL group than with trabectome alone. These results suggest that trabectome can be effectively performed at the same time as cataract surgery in the setting of primary and secondary open-angle glaucoma.33
Systematic Review of MIGS and Non-Penetrating Glaucoma Procedures for Uveitic Glaucoma
Published in Seminars in Ophthalmology, 2022
Trung Thanh Bui, Jullia A. Rosdahl
Recently, MIGS and other non-penetrating glaucoma procedures have been developed to minimize the risk of postoperative infection and inflammation with promising reported outcomes, especially in retrospective longitudinal studies. Deep sclerectomy has been shown to have a success rate between 53.4% and 62.7% in open-angle glaucoma patients at postoperative year 5.10 Xen45 gel stent has been shown to have a non-failure rate of 75 ± 4% in open-angle glaucoma patients at postoperative year 3.11 GATT has been shown to lower IOP from 26.25 ± 8.34 mmHg to 12.87 ± 1.30 mmHg in open-angle glaucoma patients at postoperative year 2.12 Trabectome has a reported success rate of 76% in open-angle glaucoma patients at postoperative year 2.13 Canaloplasty has been shown to reduce IOP by 33.6% in open-angle glaucoma patients at postoperative year 2.14
Microinvasive Glaucoma Surgery: An Evidence-Based Review
Published in Seminars in Ophthalmology, 2021
Faith A. Birnbaum, Cameron Neeson, David Solá-Del Valle
Studies comparing Trabectome and phaco/Trabectome further support Trabectome’s role as an effective standalone procedure. One prospective study found that both Trabectome and phaco/Trabectome conferred reductions in IOP and IOP-lowering medication over 1 year. However, only the Trabectome group showed statistically significant reductions in both IOP and glaucoma medications at 1 year (p < .01, for both IOP and medications), whereas the phaco/Trabectome group showed declining trends for both variables yet did not meet statistical significance for either (p = .11 for IOP, p = .24 for medications).11 A retrospective review of 1,340 eyes that had Trabectome with or without cataract surgery found that phaco/Trabectome reduced IOP by 1.29 ± 0.39 mmHg less than Trabectome alone (p < .01) over 12 months of follow-up.12 On the other hand, a different retrospective review showed that both Trabectome and phaco/Trabectome groups had significant IOP and medication burden reductions from baseline over 1 year (p < .01), and that there was no statistically significant difference between the two groups (p ≥ .05).13 Esfandari et al. published another retrospective interventional case series assessing phaco/Trabectome with 5 years of follow-up. At 5 years, 67.5% of the eyes had a ≥20% reduction in IOP, and the mean IOP had a significant reduction of 22% from baseline (p = .001).14 Trabectome seems to perform just as well as phaco/Trabectome, or at worst, phaco/Trabectome may be slightly less effective than the standalone procedure.
Overcoming diagnostic and treatment challenges in uveitic glaucoma
Published in Clinical and Experimental Optometry, 2019
Erin R Sherman, Malinda Cafiero‐chin
Currently, few surgical intervention options have undergone prospective, randomised studies. Data have been collected and recommendations have been made for minimally invasive glaucoma surgery, trabectome surgery, and canaloplasty. Each have proven to be attractive alternatives for treating UG and have shown success within the retrospective and case studies.2015 Larger well‐designed studies are needed to confirm those conclusions and to determine the safety and efficacy of those procedures.